Recent Advances in Pediatric Anesthesia Kirti N Saxena
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1Recent Advances in Pediatric Anesthesia
2Recent Advances in Pediatric Anesthesia
Editor Kirti N Saxena MBBS MD Professor Department of Anesthesiology and Intensive Care Maulana Azad Medical College and Associated Lok Nayak Hospital New Delhi, India Foreword CK Dua
3Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
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Recent Advances in Pediatric Anesthesia
© 2009, Jaypee Brothers Medical Publishers
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editor and the publisher.
First Edition: 2009
9788184486803
Typeset at JPBMP typesetting unit
Printed at Ajanta Press
4
To
The memory of my late parents
Shri Kameshwar Nath and
Shrimati Priyamvada
Who always encouraged me and taught me the value of knowledge and human values
5Contributors 6Foreword
Pediatric anesthesia is one of the most challenging sub-specialties of anesthesiology. Pediatric patients, because of their unique anatomical, physiological and pharmacological characteristics, are not treated as miniature adults and hence, extrapolation of adult data is not feasible.
It is axiomatic that advances in surgery cannot be achieved without concurrent developments in anesthesiology. Over the last two decades, there have been tremendous advances in pediatric surgical procedures and that has been possible only due to simultaneous development of appropriate management strategies and innovative technologies in pediatric anesthesia. Concurrent with these advances, there have been changes in airway management and cardio-pulmonary resuscitation of pediatric patients.
This book entitled Recent Advances in Pediatric Anesthesia intends to provide comprehensive information in a legible and simplified manner. It covers most of the important aspects of pediatric anesthesia such as: psychological preparation and premedication, perioperative fluid management, pediatric airway management, pathophysiology assessment and management of acute pain, pediatric and neonatal resuscitation, anesthesia for premature infants and anesthetic management of pediatric laparoscopic surgical procedures. The topics are very well covered with special emphasis on the recent guidelines and protocols in a tabulated manner. The topics are also adequately referenced.
It gives me immense pleasure to introduce the author of this book, Dr Kirti Nath Saxena, Professor Anesthesiology at MAMC. I have known her for more than 20 years, as a student, resident, and faculty. She is a highly dynamic and articulate author and has put in tremendous effort in compiling this book.
The author has done a commendable job reviewing various aspects of pediatric anesthesia as well as introducing the reader to newer concepts that are and will become more important in the future. I recommend this book since it would prove useful not only for the students, but also for practitioners as well as teachers. Furthermore, it will serve as an excellent reference book for other providers including surgeons and anesthesiologists who care for pediatric patients. I am sure the readers of this book will benefit substantially from it.
I wish this endeavor all success.
Dr CK Dua mbbs da md
Former Director-Professor and HOD
Department of Anesthesiology
Maulana Azad Medical College, New Delhi, India
7Preface
The field of anesthesiology is expanding so rapidly that it is difficult to keep pace with new developments every day. As an academician working and teaching in a premier medical college of India, I am priviledged to have access to the latest journals and books in my subject and have felt the need for the practitioners of my speciality to have the same. The aim of bringing out this publication is to bridge the gap between textbooks and journals. Though most of this information is available in journals, our endeavor is to present this knowledge in a concise and articulate manner in one place. It is aimed at the busy practitioners and postgraduate students specializing in this field.
This book is the first in a series on recent advances in the field of anesthesiology. The focus of this issue is on pediatric anesthesia which has seen some major pathbreaking changes which are also related to rapid strides in the field of pediatric surgery.
Kirti N Saxena
8Acknowledgements
I am thankful to my husband, Dr Yogesh Krishna Saxena and both my sons, Prashant and Anshuman, who have always encouraged and supported me in all my endeavors.
I am thankful to my head of department, Dr Raktima Anand for encouraging me to bring out this book.
I am thankful to Dr Bharti Taneja, Dr Gunjan Manchanda, and Dr Prachi Gaba for showing faith in me and working tirelessly with me to bring out this publication.
I also wish to thank Dr Amit Bhagwat, Dr Akhil Singhal, and Dr Sandhya Od, who were my students and have made me proud today by contributing to this book.
Kirti N Saxena